Q Recently, my 27-year-old brother, who has always been quite sensitive, artistic, perceptive and close to me had a big breakdown. It was very scary. I have always seen him as a quieter and more spiritual person. It started with him telling me very emotionally about his break up with his girlfriend. He was very depressed when he started and then began to get pretty angry. He told me things he had analyzed about our family, myself and some other folks we knew. It seemed he had a psychic understanding of people, their true motives, issues and personality traits. He then told me that I wasn’t as supportive as he wanted in a sister and that has greatly affected his closeness to the family and even lowered his confidence with his girlfriends in the past. I was pretty shocked at hearing all of this. When I started defending myself and told him to stop blaming me for his issues, he got verbally aggressive by threatening me and yelling at me. Fortunately, I stopped reacting and just listened and he began to calm down after about thirty minutes. I am not sure how serious his outburst is and what it means regarding his emotional health?

A This is quite a thorough description of a psychological process that is worth being very aware. Significant losses can be quite destabilizing for people. His break up and maybe other changes in his life have precipitated quite an opening, a release of deeper feelings and perceptions, where his usual inhibitions and defenses are not operating.

You mentioned “depression.”  How seriously depressed is he and for how long?  Ideally you want to encourage him to see a psychotherapist who can help him understand his current reactions, evaluate his mental state and help him work through his grief, anger and more fully diagnose his depression.  With major depression, a person’s thought processes can seem bizarre, highly perceptive and quite self-revealing. It can also move towards delusional thinking with excessive paranoia.  This can get very complex to understand, as some of the perceptions can be very accurate and others outrageous.

Sometimes the kind of aggression you described can be a manic episode, which is part of a bipolar disorder.  In a manic state a person has high levels of energy, starts to lose touch with reality, can get aggressive, and grandiose.  This can be a very creative and productive phase as well. However, it is very difficult to be around a person in this state.

Support groups play a pivotal role in dealing with episodes like this. Other people who’ve been in similar situations can share their experiences and coping mechanisms, both for you as well as your brother.

If it is indeed a manic episode, it has to be looked at professionally for if left untreated it can get worse and more difficult to treat.

Alzak Amlani, Ph.D., is a counseling psychologist of Indian descent in the Bay Area. 650-325-8393. Visit www.wholenesstherapy.com

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